The present invention relates to halo vests for use by patients with cervical or spinal injuries for immobilizing the neck of the patient to promote healing and particularly relates to a halo vest that is molded or shaped three-dimensionally to load specific muscle groups of the patient's body and avoid loading of other body portions, such as bony prominences.
Halo vests are orthopedic devices normally applied by a medical practitioner, such as an orthopedic or neurological surgeon, to a patient having cervical or spinal injuries for immobilizing the patients to promote healing which often takes many months. Conventional halo vests typically comprise a vest body having front and rear components for overlying the front and back of the patient's upper torso. The front and back body components are normally secured one to the other by flexible straps around the waist and over the shoulders. Halo support rods attach to and upstand from upper portions of the front and back body components for supporting a halo about the patient's head, the head being secured within the halo by a surgical procedure. A typical halo vest is described and illustrated in co-pending U.S. patent application Ser. No. 07/474,288, filed Feb. 5, 1990, that particular application being directed to an improved lining for the front and back components of the vest body.
The front and back components of a typical halo vest are often formed of flat pieces of material, trimmed to the desired shape or outline and then bent or curved into a shape to encompass the upper torso. The bending is essentially a two-dimensional, non-compound bend so that the front and back components will substantially parallel the lateral curvature of the upper torso. Trimming the components to a particular outline avoids some of the problems associated with supporting the vest on certain parts of the body, such as bony body prominences. However, certain bony prominences cannot be avoided by trimming or outlining. Thus, conventional halo vests typically rest on and are supported by, albeit with padding disposed therebetween, certain of the bony prominences of the body. This not only can lead to patient discomfort but the pressure or load of the halo vest on the bony prominences tends to destroy the skin and tissue between the prominences and the material of the vest components. Ulceration of the skin frequently occurs. These problems have long been recognized. However, the typically preferred solutions to these problems, for example, to avoid the bony prominences in the spinal area on the back of the patient, have been to apply more padding or attempt to trim the vest components about them. Trimming, of course, is severely limited because of the distribution of the bony prominences about the body and the need for structural support for the halo from a relatively rigid structural vest which, in turn, transmits the loading to the patient's body. Additional padding is not a solution because, even with padding, there is a compacted mass of material between the hard vest component and the bony prominence which prevents moisture from escaping between the skin and the vest and hence promotes skin and tissue problems.
Additionally, many conventional vests, when trimmed, are left with flat or relatively sharp edges. Upon patient movement, the sharp edges oftentimes pinch the adjoining skin. This can cause substantial annoying irritation and bruising of the skin and, of course, patient discomfort.
According to the present invention, there is provided a shaped halo vest having front and back components which are not only trimmed to the desired outline, but are shaped or molded three-dimensionally to (a) transfer loads imposed by the vest to the patient's body only onto specific and selected muscle groups; (b) avoid transfer of loads from the vest onto other selected areas of the body, i.e., bony prominences; and (c) avoid sharp pressure points on the patient's skin along their marginal edge. Additionally, the molded or shaped three-dimensional compound curves of the front and back components of the present halo vest enhance the strength and structural rigidity of the vest whereby such shape enables the vest to be formed of reduced material and weight. By selective three-dimensional shaping of the vest components, loading on the vest can be transferred to selected locations along the upper torso to avoid bony prominences, to load selected muscle groups which can withstand the loading, and also to increase air circulation between the vest and the patient's body. The present vest is therefore skin tissue-friendly and avoids many of the problems associated with the continuous application of pressure and loading onto various areas of the body.
As an example of the shaping of the vest components according to the present invention, it will be appreciated that the vest back component overlies the spinous processes. These constitute bony prominences along the spine. In that area, the vest back is three-dimensionally shaped to avoid application of pressure to those prominences. Accordingly, the back component is bowed outwardly as well as curved in a vertical direction in the area thereof that overlies and registers with the spinous processes. The lining follows this compound curvature of the vest back component and, hence, produces a spacing between the vest and the patient's body, enabling flow of air therebetween. More particularly, openings are provided through the back vest component in areas overlying the spinous processes. The openings lie in the outwardly directed bulbous parts and hence enable air to circulate between the vest liner and the patient's skin.
Concomitantly, the back vest component is shaped to transfer loadings on the vest to selected muscle groups for supporting the vest. For example, the back vest component is shaped, i.e., bowed inwardly three-dimensionally, in selected areas therealong to distribute the loadings on the vest to the trapezius, latissimus dorsi and erector spinae muscle groups on opposite sides of the spinous processes and laterally inwardly of the spine of the scapula and the tendons connecting it and the trapezius muscle. Thus, the back vest component is shaped to apply loadings along these muscle groups in generally vertical extended areas on either side of the spinous processes from the neck down to the bottom of the rib cage. Loading is therefore applied to the desired areas of the body and not applied to those areas which are likely to cause damage to the underlying skin and tissue or cause patient discomfort.
The front vest component is similarly shaped to avoid application of loadings to selected areas and to apply loadings to other selected areas. Thus, the front vest component is three-dimensionally bowed outwardly along a central vertically extending portion overlying the sternum while laterally outwardly and on opposite sides of the central portion the front vest component is bowed three-dimensionally inwardly to apply loadings to the underlying pectoralis muscle groups.
In accordance with a further aspect of the present invention, the marginal edges of the front and back vest components are flared outwardly. Any relative movement between the vest and the individual's body thus avoids application of sharp pressure points along the patient's skin adjacent the outline of the vest components. The three-dimensional shaping on the front and back vest components including the flared margins also increases the structural strength of the vest components, enabling use of thinner materials as compared with the thickness of the materials used in conventional vests and hence a lighter vest.
There are various other improvements in the present vest which will become apparent upon reference to the specifically disclosed embodiment of the vest. Such improvements include shoulder straps dimensioned to overlie an area of the shoulder between the bony prominences and the patient's neck, hence, increasing the comfort of the patient and avoiding problems associated with loadings on the patient's skin. Additionally, the straps about the sides of the torso joining the lower ends of the front and back vest components are of unique configuration, as will be pointed out in the ensuing description.
In a preferred embodiment according to the present invention, there is provided a halo vest for a human wearer, comprising a vest body of structural material having front and back components for overlying the front and back, respectively, of the wearer. Halo support elements are secured to the vest body. The vest body has first discrete portions for transferring loading on the vest including from the halo support elements to first selected areas of the wearer's body underlying and registering with the first discrete portions, respectively, and second discrete portions, spaced from the first discrete portions, for avoiding transfer of loading on the vest, including from the halo support elements, to second selected areas of the wearer's body underlying and registering with the second discrete portions, respectively.
In a further preferred embodiment according to the present invention, there is provided a vest for a human wearer, comprising a vest body of substantially rigid molded structural plastics material having front and back components for overlying the front and back, respectively, of a wearer. Support elements are provided on the body for supporting loads. The vest body has first discrete portions for transferring loading from the support elements to first selected areas of the wearer's body underlying and registering with the first discrete portions, respectively, and second discrete portions spaced from the first discrete portions, for avoiding transfer of loading on the vest, including from the support elements to second selected areas of the wearer's body underlying and registering with the second discrete portions, respectively, the second discrete portions including portions on the back component for bridging the spinal processes and portions of the front component for bridging the sternum, the first portions located along the back component for overlying the trapezius, latissimus dorsi and erector spinae muscle groups and the first portions located along the front component for overlying the pectoralis muscle groups, the bridging portions comprising three-dimensional outwardly curved molded portions.
Accordingly, it is a primary object of the present invention to provide a novel and improved halo vest which is shaped three-dimensionally in selected areas of its front and back components to transfer loadings on the vest to selected areas of the body and avoid transfer of loadings on the vest to other selected areas of the body, i.e., bony prominences, whereby a vest of increased comfort, structural rigidity and increased friendliness to skin tissue is provided.
These and further objects and advantages of the present invention will become more apparent upon reference to the following specification, appended claims and drawings.